Chemical abscess post vein of Galen aneurysmal malformation embolisation with ethylene vinyl alcohol copolymer

Abstract

Vein of Galen aneurysmal malformation (VGAM) is a rare congenital malformation characterised by arteriovenous fistulas between primitive choroidal arteries and the median prosencephalic vein, the embryonic precursor to the vein of Galen. Endovascular techniques have changed the management of these patients with improved prognosis. An eight-month-old with VGAM managed by endovascular embolisation using ethylene vinyl alcohol copolymer (EVOH) developed a chemical abscess - a rare complication. It was managed conservatively and showed promising clinical outcome. Contribution: Chemical abscesses following EVOH embolisation are scarce – with imaging differentials, which include brain abscess and onyx granuloma. Knowledge and successful identification of this entity are essential as its management as prognoses differ. Chemical abscess is managed conservatively and has a good prognosis.

Keywords

• vein of galen
• endovascular embolisation
• ethylene vinyl alcohol copolymer (onyx)
• chemical abscess
• onyx granuloma
• brain abscess
• vgam
• vein of galen malformation.